Individual
MARY KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
138 E MAIN ST, WESTFIELD, NY 14787-1121
(716) 326-4678
(716) 326-4641
Mailing address
PO BOX 10, WESTFIELD, NY 14787-0010
(716) 326-4678
(716) 326-4641
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/17/2018
Last updated
05/10/2022
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